Uneventful Cesarean Section in A Woman with Normotensive Asymptomatic Bifocal Pheochromocytoma Without Preoperative Alpha Blockade Preparation

Author Info

Hassan Shawa Jamila A Benmoussa Sara Clark

Corresponding Author

Hassan Shawa
Albany Medical Center, Endocrinology and Metabolism Department, Albany, NY 12208

A B S T R A C T

Context: There are no guidelines on the management of pheochromocytoma (PCC) diagnosed during pregnancy due to the rarity of the condition. Case Description: A 30-year-old woman with MEN 2A due to a germline mutation in exon 11 of the RET oncogene. She underwent a prophylactic total thyroidectomy at the age of 12 with pathology showing multifocal microscopic medullary thyroid carcinoma. At the age of 20, she was found to have elevated catecholamines and CT of the abdomen revealed a 2.1 cm left adrenal pheochromocytoma. She was asymptomatic and normotensive. She underwent an eventful laparoscopic left adrenalectomy preceded with taking doxazosin 1 mg daily for 3 weeks. At the age of 29, she was found again to have elevated catecholamines while being pregnant. MRI of the abdomen revealed a 3.3 cm right adrenal pheochromocytoma. She remained asymptomatic and normotensive throughout the pregnancy. Elective uneventful C-Section was performed at week 38 without preoperative medical preparation. Postpartum, she remained asymptomatic while breastfeeding. She underwent uneventful laparoscopic right adrenalectomy eight months after delivery proceeded by taking phenoxybenzamine 10 mg twice/day for 10 days during which time she suffered stuffy nose, fatigue, and orthostasis. Pathology interestingly revealed bifocal pheochromocytomas in both adrenal glands. Conclusion: We present a normotensive asymptomatic pregnant with PCC who underwent an elective uneventful C-Section without alpha-blockade preparation with excellent maternal/fetal outcomes. To the best of our knowledge, no similar case has been reported thus far. Preoperative medical preparation may not be needed in asymptomatic normotensive pregnant patients with PCC undergoing C-Section.

Article Info

Article Type

Case Report

Publication history

Received: Mon 15, Oct 2018
Accepted: Fri 02, Nov 2018
Published: Fri 28, Dec 2018

Copyright

© 2023 Hassan Shawa. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2018.03.016